Evidence map›Paper›PMID 29080904›Full record

Observational studyPsychopharmacology2018

Antipsychotic polypharmacy prescribing and risk of hospital readmission.

Giouliana Kadra, Robert Stewart, Hitesh Shetty, James H MacCabe, Chin-Kuo Chang, Jad Kesserwani, David Taylor, Richard D Hayes

Abstract readObservational Study
PubMed Full text at PMC Publisher
In one paragraph

Observational study in Psychopharmacology, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

23 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Article
  4. Observational
  5. Prevalence and predictors of high-dose antipsychotic therapy among adult psychiatric inpatients in Baghdad, Iraq.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026
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  6. Profile of male acute admissions at a state psychiatric hospital in the Western Cape, South Africa.The South African journal of psychiatry : SAJP : the journal of the Society of Psychiatrists of South Africa · 2026
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Giouliana KadraInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK. giouliana.kadra@kcl.ac.uk.
Robert StewartInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK.
Hitesh ShettySouth London and Maudsley NHS Foundation Trust, London, UK.
James H MacCabeInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK.
Chin-Kuo ChangInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK.
Jad KesserwaniInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK.
David TaylorSouth London and Maudsley NHS Foundation Trust, London, UK.
Richard D HayesInstitute of Psychiatry, Psychology and Neuroscience, King's College London, BRC Neucleus, Mapother House, De Crespigny Park, London, SE5 8AF, UK.

Funding

Medical Research Council MC_PC_17214Medical Research Council MR/J01219X/1Medical Research Council MR/L011794/1
6 · The paper itself

Abstract

objectivesThe aim of this study was to determine if there was an association between being discharged on antipsychotic polypharmacy (APP) and risk of readmission into secondary mental health care.

methodsUsing data from the South London and Maudsley (SLAM) case register, service users with serious mental illness (SMI), discharged between 1st January 2007 and 31th December 2014, were followed up for 6 months. Patients were classified as receiving either monotherapy or polypharmacy at index discharge. Multivariable Cox regression models were constructed, adjusting for sociodemographic, socioeconomic, clinical and service use factors.

resultsWe identified 5523 adults who had been admitted at least once to SLAM, of whom 1355 (24.5%) were readmitted into secondary mental health care. In total, 15% (n = 826) of patients were discharged on APP and 85% (n = 4697) on monotherapy. Of these, 30.9% (n = 255) and 23.4% (n = 1100) were readmitted respectively. Being discharged on APP was associated with a significantly increased risk of readmission, in comparison to patients discharged on monotherapy (HR = 1.4, 1.2-1.7, p < 0.001). This association was maintained in the fully adjusted model and following several sensitivity analyses. We further established that patients receiving clozapine APP (n = 200) were at a significantly increased risk for readmission in comparison to patients on clozapine monotherapy (HR = 1.8, 1.2-2.6, p = 0.008).

conclusionsOur results suggest that patients discharged on APP are more likely to be readmitted into hospital within 6 months in comparison to those discharged on monotherapy. This needs to be considered in treatment decisions and the reasons for the association clarified.

Indexed as

AdultAgedAntipsychotic AgentsClozapineDrug Therapy, CombinationFemaleHumansMaleMiddle AgedPatient ReadmissionProportional Hazards ModelsRegression AnalysisRetrospective StudiesRisk FactorsAntipsychotic AgentsClozapineAntipsychoticsCo-prescribingPolypharmacyReadmissionRehospitalisation

Identifiers

PMID29080904
PMCPMC5748404

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.